After a diagnosis, it's normal to worry about cancer treatment and fertility. After all, chemotherapy treatment for breast cancer has many side effects, one of which is estrogen suppression. This can cause your ovaries to stop working for a while. Your regular cycles may stop, and you might experience medical menopause, or chemopause. In addition, there’s a good chance that you will be infertile during treatment. If you are not already in menopause before you start chemo, consider your options before you begin treatment.
Menopause and Infertility May Not be PermanentDepending on your menopausal status before treatment, your cycles and your fertility may return, 6 to 12 months after chemotherapy is complete. But if you are edging toward menopause when you begin treatment, chemo may put you over the edge.
Sex, Pregnancy, and ChemoDuring treatment, even if your periods stop, you may still be producing eggs, and it is may be possible to conceive. That’s why using contraception is necessary, because chemotherapy drugs will cause damage to the fetus. You can still have sex during treatment, if both partners are comfortable with that. However, if you are having menopausal symptoms, and fatigue, you might prefer intimacy to intercourse. Keep communication open and frequent, as these issues impact your relationships.
Factors Affecting Ovarian Damage From ChemoEach of us is at a different stage of life, and we respond to chemotherapy differently. In addition, not all drugs given for breast cancer are the same for each patient, and doses vary as well. Researchers say that your chances of regaining fertility depend on:
- age at treatment
- dose (amount of drug) given
- type of drugs used
Your Options for Keeping FertilityIf you plan to have children after chemotherapy, and your doctor agrees that it’s safe to attempt conception, you have some options:
- ovarian suppression therapy to prevent chemo-damage to the eggs
Pregnancy After Chemotherapy for Breast CancerThe American Cancer Society says, “Despite concerns that pregnancy could cause cancer to return, studies to date have not shown this to be true for any type of cancer.” Most breast cancer survivors who wish to have children after treatment worry about the pregnancy’s hormonal changes causing a recurrence. Studies have shown no difference in survival rates for women with or without post-treatment pregnancies. However, if chemo or radiation has damaged the heart, lungs, or uterus, you may need to see a specialist in high-risk obstetrics. Speak with your health-care team about your concerns regarding your fertility before you begin treatment.
Cancer Research UK. About women's fertility during chemotherapy. Last Updated: March 23, 2004. http://www.cancerhelp.org.uk/help/default.asp?page=326
ABC7 TV. Protecting Fertility During Chemo. Last Updated: December 20, 2005. http://abclocal.go.com/kgo/story?section=edell&id=3744715
American Cancer Society. Detailed Guide: How does cancer treatment affect fertility in women? Last Updated: September 18, 2006.